OCTOBER 20239Clinical governance and oversight of the quality of record keeping, together with staff satisfaction will provide perspective about where support and intervention is required, and key measures such as patient flow and incident reporting will provide core metricsWho is going to own it?Engagement with users regarding this change process and the opportunities this presents will build trust and allow them to engage with it, helping them take ownership of the functionality. This process is essential for appropriate design and adoption, and to ensure the effectiveness of the solution. The drive for change and uptake must also be understood and enabled by senior management, so that they may drive compliance and engagement. Without this, the systems build and adoption will be sub-optimal, leading to holes in data and reporting which may result from inappropriate function or poor optimisation. Who is going to lead it?The opportunity of new functionality sometimes causes a wave of change, especially from those who are especially keen to take advantage to exploit what is on offer. But change fatigue and a glut of function, beyond the necessary, may leave many feeling overwhelmed and frustrated. Senior leadership must drive the need and give the context, clinical specialists should work with the technical team to create essential function, but understanding of professional identity will be essential to further shape the processes and workflows and allow support of organisational distinctiveness and purpose.What are the safeguards?Robust programme management processes are essential so that risks and issues present, in both the implementation and the maintenance phases, may be mitigated. For example, in the UK the Digital Clinical Safety Officer and their team may be tasked with overseeing key guidance for system build and adoption, and the Clinical Governance Team, will oversee issues of adoption and compliance.The role of bodies like these cannot be overstated, as they will be critical in providing assurance to patients and regulatory bodies about the robustness of safety processes.How do you maintain the service and maintain quality? Digital adoption will affect clinical and operational working and there is no way of avoiding changes to clinical and operational working. The move from paper or a legacy electronic system will always require a detailed review of how services are delivered and a robust plan for mapping and surfacing what changes to working processes are required and the opportunities these will offer. Education and training for use of the system is essential and will come out of system operational design and build. This must continue beyond go-live, which is also true for operational and programme support, which will require a designated team of technical and clinical specialists. Planning, build and go-live is only the start of the process, comprehensive oversight and support must continue for the life of the service.How do you measure success?Clinical governance and oversight of the quality of record keeping, together with staff satisfaction will provide perspective about where support and intervention is required, and key measures such as patient flow and incident reporting will provide core metrics. The programme may also benefit being measured against national and legislative reporting obligations and national initiatives, in the UK examples of these include the Maternity Services data Set and the What Good Looks Like framework.What's the bottom line?·Application the choice of solution and the way it is implemented will dictate the scope of the project.·Integration will always be essential, both between different clinical systems and clinical workflows.·Operation the organisation must own, support and strategize system use, to promote the generation of key operational data.·Implementation comprehensive support of system development and use must carry on after the rollout has completed.
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